人之所以滋养其身者,唯气与血。呼吸定息,卫气之常,失常则为咳嗽;津液流润,荣
血之常,失常则为痰涎。咳嗽吐痰,气血已乱矣。顾世治嗽之药极多,而卒不能遍效者,盖
其致病之因不一。世谓五嗽,且以五脏而言之,要之内因七情,外合六淫,饮食起居,房劳
叫呼,皆能单复倚互而为病。故《经》云∶五脏六腑,感寒热风湿,皆令人咳。又微寒微
咳,厉风所吹,声嘶发咳;热在上焦,咳为肺痿;秋伤湿,冬咳嗽,皆外所因。喜则气散,
怒则气激,忧则气聚,思则气结,悲则气紧,恐则气却,惊则气乱,皆能发咳,即内所因。
其如饮食生冷,房劳作役,致嗽尤多,皆不内外因。其可一法而治之?治之,当推其三因,
随脉证治疗,散之,下之,温之,吐之,以平为期。
伤风咳者,憎寒壮热,自汗恶风,口干烦躁;伤寒咳者,憎寒发热,无汗恶寒,烦躁不
渴;伤暑咳者,烦热引饮,口燥,或吐涎沫,声嘶咯血;伤湿咳者,骨节烦疼,四肢重着,
洒洒淅淅,并属外所因。诊其脉,浮为风,紧为寒,数为热,细为湿。随其部位,与人迎相
应;推其脏腑,则见病源也。
喜伤心者,咳而喉仲介介如肿状,甚则咽肿喉痹,名为心咳;不已,则小肠受之,小肠
咳状,与气俱失。怒伤肝者,咳而两胁下痛,甚则不可以转,转则两 下满,名为肝咳
;不已,则胆受之,胆咳之状,咳呕胆汁。思伤脾者,咳而右胁下痛,阴阴引肩背,甚则不
可以动,名为脾咳;不已,则胃受之,胃咳之状,咳而呕,呕则长虫出。忧伤肺者,咳而喘
息有声,甚则唾血,名为肺咳;不已,则大肠受之,大肠咳状,咳而遗失。恐伤肾者,咳而
腰背相引痛,甚则咳涎,名为肾咳;不已,则膀胱受之,膀胱咳状,咳而遗溺,久咳不已,
则三焦受之。三焦咳状,咳而腹满不欲食。此等皆聚于胃,关于肺。肺取 俞最近,故内因
多先有所感,世人并名肺咳嗽也,并属内所因。诊其脉,随其部位,与气口相应,浮紧则虚
寒,沉数则实热,弦涩则少血,洪滑则多痰。以此类推,无施不可。
What nourishes the human body is solely Qi and Blood. Regular respiration, with a steady interval between breaths, is the normal state of Wei Qi (Defensive Qi); when this state is disrupted, it leads to cough; the flowing and moistening of body fluids is the normal state of Ying Blood (Nutritive Blood); when disrupted, it produces phlegm and saliva. Coughing accompanied by expectoration indicates that Qi and Blood have already become disordered.
Although there are numerous medicines in the world for treating cough, they ultimately cannot be universally effective, largely because the causes of disease vary. The so-called "Five Coughs" discussed by people are described from the perspective of the Five Zang Organs. However, essentially, internal factors such as the Seven Emotions (Joy, Anger, Worry, Pensiveness, Sorrow, Fear, Fright), external factors such as the Six Excesses (Wind, Cold, Summer-heat, Dampness, Dryness, Fire), improper diet and daily life, excessive sexual activity, or loud shouting, can all cause disease either singly or in combination. Therefore, the *Classic* states: "The Five Zang and Six Fu organs, upon contracting cold, heat, wind, or dampness, all cause cough." Additionally, slight cold induces slight cough; being blown by fierce wind causes hoarseness and cough; heat in the Upper Jiao (Upper Burner) leads to Lung Wei (Lung Atrophy/Withering); injury by dampness in autumn and cough in winter are all external causes. Joy scatters Qi, anger agitates Qi, worry gathers Qi, pensiveness knots Qi, sorrow tightens Qi, fear sinks Qi, and fright disorders Qi; all these can induce cough, constituting internal causes. As for cough caused by consuming raw/cold foods or overexertion due to sexual activity or labor, these are particularly common and belong to neither internal nor external causes, termed "neither internal nor external causes." Can one single method treat them? Treatment must deduce the Three Causes, and based on pulse and syndrome differentiation, employ methods such as dispersing, purging, warming, or inducing vomiting, aiming to restore balance.
Cough due to Wind Injury presents with aversion to cold and high fever, spontaneous sweating, aversion to wind, dry mouth, and irritability; Cough due to Cold Injury presents with aversion to cold and fever, absence of sweating, aversion to cold, irritability, but no thirst; Cough due to Summer-heat Injury presents with vexatious heat and desire for drinking, dry mouth, possibly vomiting saliva, hoarseness, or hemoptysis; Cough due to Dampness Injury presents with painful joints, heavy limbs, and a sensation of chilliness (shivering). These all belong to external causes. Upon examining the pulse, floating indicates Wind, tight indicates Cold, rapid indicates Heat, and fine indicates Dampness. Corresponding to the Renying acupoint (Renying, ST9, used to assess Yang meridians) based on the location of the pathology; and by deducing the involved Zang-Fu organs, the source of the disease can be identified.
Excessive Joy damages the Heart, causing cough with a sensation of swelling in the throat, and severely, sore throat and throat obstruction; this is named Heart Cough. If unresolved, it transmits to the Small Intestine; Small Intestine Cough presents with cough accompanied by flatus. Excessive Anger damages the Liver, causing cough with pain under both hypochondria, and severely, inability to turn the body, turning causes fullness under both hypochondria; this is named Liver Cough. If unresolved, it transmits to the Gallbladder; Gallbladder Cough presents with cough and vomiting of bile. Excessive Pensiveness damages the Spleen, causing cough with pain under the right hypochondrium, radiating faintly to the shoulder and back, and severely, inability to move; this is named Spleen Cough. If unresolved, it transmits to the Stomach; Stomach Cough presents with cough and vomiting, where roundworms may be expelled. Excessive Worry damages the Lungs, causing cough with wheezing and audible breathing sounds, and severely, spitting blood; this is named Lung Cough. If unresolved, it transmits to the Large Intestine; Large Intestine Cough presents with cough accompanied by loss of stool and urine. Excessive Fear damages the Kidneys, causing cough with pulling pain between the waist and back, and severely, coughing up saliva; this is named Kidney Cough. If unresolved, it transmits to the Bladder; Bladder Cough presents with cough accompanied by urinary incontinence. Chronic cough that does not resolve transmits to the Sanjiao (Triple Burner). Sanjiao Cough presents with cough, abdominal fullness, and lack of appetite. All these conditions gather in the Stomach and relate to the Lungs. Since the Shu points of the Lungs (Back-Shu points of the Lung) are closest, internal causes often involve prior sensory/emotional impact, which people generally name as Lung Cough; these all belong to internal causes. Upon examining the pulse, corresponding to the Qikou acupoint (Radial artery at the wrist, used to assess Yin meridians and Zang organs) based on location, floating and tight indicates deficiency-cold, deep and rapid indicates excess-heat, wiry and choppy indicates blood deficiency, and surging and slippery indicates excess phlegm. By analogy, no treatment is impossible.